Poster Index

Lifespan differential aspects (from infancy to elderly)

Clinical and neurocognitive studies of suicidal behavior (17)  |  Clinical phenotyping of suicidal individuals (23)
Culture, ethnicity and spiritual approaches. New paradigms in suicidology (11)  |  Ethical and methodological challenges and solutions in suicide research (5)
Genetic, epigenetic and gene expression contributors to suicide risk (2)  |  Intervention research for prevention of suicidal behavior (30)
Lifespan differential aspects (from infancy to elderly) (7)  |  Miscellany (assisted suicide, minorities, legal aspects, etc.) (9)
Neurobiological underpinnings of suicidal behavior (3)  |  Novel monitoring strategies for detecting changes in risk over time (4)
Psychosocial variables: protective and risk factors. Resilience & vulnerability (38)  |  Testing the effectiveness of prevention strategies (6)




Lifespan differential aspects (from infancy to elderly)


(169) PO-169. Postpartum psychosis and suicide attempt

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Antonio España Osuna . Complejo Hospitalario de Jaen, Jaen
- Mercedes Valverde Barea - Francisca Cartas Moreno -

 Introduction:
Postpartum psychiatric complications include sadness, depression and psychosis. In the last two cases the risk of suicide is increased so that the intervention should be early, energetic and often requires hospitalization and social and family intervention.
 Goals:
Autolytic provide an example of a serious complication in the postpartum psychotic disorder.
 Methodology:
Present illness: The patient gave birth two weeks before the onset of symptoms. Since then he has made several attempts autolytic knife and attempted strangulation. Shows perplexity, self-referentiality, delusional and psychomotor retardation.
Psychopathological exploration: psychomotor slowing, stiffness and facial blankness in puzzlement. Inattentive. Hypothymic affection, personnel and underestimation ambivalent about the actual suicide attempts and suicidal ideation. Imperative auditory hallucinations. Delusional interpretations of their environment and labor. Self-referentiality and contriving jealousy for her husband. Insomnia. Decreased appetite. Partial insight. Scale Edinburgh on postpartum depression (EPDS) score: 21.
Diagnosis: Puerperal psychoses without specification.
 Results:
The patient had an adequate response to hospitalization and establishment of antipsychotic treatment with Olanzapine gradually decreasing alterations in sensory perception, mood and thought content. Drug dosage was titrated to 15 mg a day. During her internment she was accompanied at all times by her husband and not staged any autolytic act. Significantly, the beneficial effect on the progressive and she had protected exposure to newborns in an attempt to establish an early bonding child. There was a multidisciplinary strategy that were involved psychiatrist, psychologist, social worker and family physician established.
 Conclusions:
1. Postpartum mood disorders are very common and range from sadness, depression and psychosis.
2. The severity and frequency together with the involvement of the newborn and the rest of the family in question make a real public health problem. To this is added a higher incidence of suicide and extended staff.
3. Antipsychotic treatment, along with supportive psychotherapy, family and social intervention are the therapeutic pillars.
 References:
1. Medina-Serdán E. Diferencias entre la depresión postparto, la psicosis postparto y la tristeza postparto. Perinatol Reprod Hum 2013; 27 (3): 185-193.
2. Oviedo GF, Jordán V. Trastornos afectivos posparto. Universitas Médica. 2006; 47: 131-40.


(270) PO-270. After the suicide of a relative or a friend: The grief experiences of adolescents

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Karl Andriessen . School of Psychiatry, University of New South Wales, Randwick 2031 NSW, Australia
- Brian Draper - Michael Dudley - Elizabeth A. Lobb - Jane Mowll - Philip B. Mitchell -

 
 Goals:
The grief experiences of adolescents are not well understood. The impact of the loss should be studied within a broad context including risk factors for maladaptive outcomes, as well as protective factors. The study aims to explore the grief experience of adolescents including (1) pre-loss features related to personal and/or family history of mental health, family life, suicidal behaviour, kinship and psychological closeness of relationship; (2) cause of death and; (3) post-loss issues, e.g., how the death was communicated, and quality of remaining relationships. Phase one of the study involves a semi-structured telephone interview with adolescents who have lost a relative/friend by suicide or other type of death when they were aged between 12 and 18 years old, and experienced the loss between six months and ten years ago. Phase two will be informed by the interviews and involve a survey regarding psychiatric morbidity, grief, suicide risk and protective factors, kinship and closeness of relationship. Preliminary results show that the loss may have a lasting impact, irrespective of the cause of death. The familial context, the mental health of the bereaved adolescent, the meaning attributed to the relationship with the deceased person, and the quality of remaining relationships appear to be important in the grief experience and coping with the loss.
 Results:
The study findings will inform guidelines and recommendations for clinicians, community service providers and school counsellors on how to better support bereaved adolescents.


(313) PO-313. Suicide in Children and Young People in England

Day: 10 | Time: 10:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Pauline Turnbull . The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Manchester - England
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 Introduction:
Suicide is one of the main causes of mortality in young people, and the impact on families can be extremely distressing. Suicide rates are linked to age, and increase markedly from mid-teens to early twenties. Investigating young deaths would help to explore what happens as children age to increase their suicide risk.
 Goals:
We aimed to examine the antecedents of suicide in children and young people.
 Methodology:
National suicide data were obtained for individuals aged 10 to 19 who died by suicide between January 2014 and April 2015. Data were collected from investigations by official bodies in England, including but not restricted to coroner’s inquests, local authority investigations, and NHS investigations. If an issue was not present in a data source, it was recorded as absent. Pearson’s chi square tests examined associations between the groups.
 Results:
We were notified of 145 suicides by young people, and we obtained data on 130 of these. There were more males than females, and the number of deaths increased into the late teens. Hanging was the most common method of death (92, 63%). The second most common method was jumping from a height or in front of a moving vehicle (31, 21%). Sixty-nine (57%) were in education at the time of death, and many of those were experiencing educational pressures. Bullying was mentioned in 26 cases (20%). Face-to-face bullying was more common than cyber-bullying. Thirty-six (28%) had been bereaved, 17 of those (47%) by suicide. Physical illness was common (47, 36%), mostly dermatological and respiratory problems.
 Conclusions:
Children and young people who die by suicide are a complex group with many risk factors. There is an escalation of suicide in later teen years. Areas of particular concern are age and gender differences, academic pressures, bereavement, and physical illness.


(333) PO-333. Self-injurious thoghts and behaviors as risk factors of suicide attempts and completed suicide in adolescence and young adulthood: A systematic review and meta-analysis

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Pere Castellvi . Fundacio IMIM Hospital del Mar, Barcelona - Spain
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 Introduction:
Previous self-injurious thoughts and behaviors (SITB) are the strongest risk factor of future suicidal behaviors. No meta-analyses have been conducted for a comprehensive set of SITB among the general youth population.
 Goals:
We assessed the association and magnitude of the effect of a variety of previous SITB with subsequent suicide attempt and completed suicide in adolescence and young adulthood.
 Methodology:
We searched 6 major international databases and grey literature until June 2015. Inclusion criteria were: 1. Assessment of any type of SITB as risk factor of suicide attempt or completed suicide: a) suicidal behavior (ideation; plan; attempt); b) non-suicidal behavior (non-suicidal self-injury; self-injury thoughts); c) self-harm; and d) suicide threat; 2. Case-control or cohort studies; 3. Subjects aged 12-26 years old. Random models were used. (Reg: CRD42013005775).
 Results:
From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). A history of any previous SITB was significantly associated with suicide attempts in adolescence/youth (OR = 3.48, 95%CI = 2.73-4.44; I2 = 88), the risk for previous suicidal behaviors was higher (OR = 3.88, 95%CI = 2.91-5.17; I2 = 87%) than for previous non-suicidal behaviors (OR = 2.26, 95%CI= 1.26-4.07; I2 = 75%). For completed suicide, any previous SITB were very strongly associated (OR = 22.3, 95%CI = 18.7-27.19; I2 = 0%).
 Conclusions:
All types of early SITB entail a risk of future suicide attempts and, particularly, suicide death in adolescence and young adulthood. Effective programs to outreach this population are needed to reduce recurrent suicidal behaviors.
 References:
FUNDING: ISCIII- FEDER (PI13/00343), CIBER (CB06/02/0046); MSSSI-PNSD (Exp. 2015I015); AGAUR (2014 SGR 748).


(384) PO-384. Suicidal feelings in 85-year-olds: A birth cohort comparison study

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Margda Waern . University of Gothenburg, Gothenburg, Sweden
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 Goals:
Over the past decades, there have been significant changes in general health and overall living situation for older adults. Octogenarians of today are better educated, have better health, less disability and better cognitive function compared to those who were in their eighties several decades ago. We hypothesized that we would find reduced rates of suicidal feelings, as well. The aim of this study was to compare the prevalence of suicidal feelings in two birth cohorts of 85-year-olds, born in 1901-02 and 1923-24.
 Methodology:
Data were derived from the multidisciplinary H85 study, a gerontological and geriatric population study in Gothenburg, Sweden. Participants were systematically selected from the population register. The 1901 cohort included 345 persons and the 1923 cohort 431 persons. Participants took part in a psychiatric examination that included the Paykel questions about suicide feelings (weariness of life, death wishes, suicidal thoughts and attempts). Symptoms were rated by the Comprehensive Psychopathological Rating Scale.
 Results:
We noted a reduction of past month suicidal feelings in the later-born cohort. Suicidal feelings were observed in 15.9% in those born in 1901 and 8.1% of those born in 1923 (p=0.001). The difference was driven, however by a significant decrease in women (18.7% vs 10.2%, p=0.007). Women in the latter-born cohort were less likely to report milder suicidal feelings (weariness of life, death wishes). There was a trend for depressed men in the later-born cohort to report serious suicidal feelings, including attempts, to a larger degree than depressed men in the earlier born cohort.
 Conclusions:
We observed a secular change with decreasing rates of suicidal feelings in 85- year-olds, but this was due to a reduction of suicide feelings in women only. Findings have implications for public health, highlighting the need for suicide prevention programs tailored to older men.


(423) PO-423. Childhood adversities and Suicide Attempts

Day: 10 | Time: 10:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Anna Plaza . Crisis Intervention and Suicide Prevention Unit, Barcelona
- David Closas - Roser Blanqué - Carmen Pinedo - Luis De Ángel -

 Introduction:
Research to date indicates that a history of childhood abuse is associated with suicidal behaviour, but little research has examined the unique contributions of specific types of childhood adversities (CAs) and specific characteristics of those CAs (perpetrator, frequency, age).
 Goals:
To examine the association between a history of Childhood Adversities (childhood physical, emotional and sexual abuse, parental substance abuse, witnesses of familial violence, parental death, and parental separation or divorce) and the presence of suicide attempts (SA) as well as the number of previous SA.
 Methodology:
A sample of twenty patients (N=20) who have made at least one suicide attempt and a sample of twenty patients (N=20) who have not, were selected to participate in the study. The subjects were recruited from a Unit of Crisis Intervention and Suicide Prevention (UCI-SP). Socio-demographic variables and other variables related to the suicide attempts (number of previous suicide attempts, severity, level of rescue and method) were selected from the usual protocol of the UCI-SP. The presence of a history of CAs and its characteristics was evaluated by the ETI-SF and ETI-SR (Bremner et al., 2007). Chi square analyses, Student’s t-test, and the Mann-Whitney U test, as well as Pearson and Spearman Rho were carried out. Binary logistical regression was done with the presence of SA as dependent variable.
 Results:
The presence of suicide attempts was not significantly associated with any of the socio-demographic variables, and within the CAs, only the presence of childhood physical abuse (p≤0.011) was associated with the presence of SA. Within the patients who had suffered emotional abuse, the variable “age when abuse occurred” was significantly associated with the presence of SA (p≤0.016). Parental substance abuse was associated with more previous SAs (p≤.0.042). The scale of physical abuse also correlated with the number of SAs (r=. 434; p≤0.021). Binary Logistical regression showed that the presence of physical abuse is the only variable that remains in the model (OR: 2.903 (1.22-7.508); p≤ 0.28).
 Conclusions:
A history of childhood abuse, especially physical abuse, must be evaluated in those patients admitted to Crisis Intervention Units to help identify suicide risks.


(426) PO-426. Prevention of Suicide Among Adolescents in Kazakhstan: Evidences from Kyzylorda Oblast

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Saylybayev Bakytzhan . Educational Department, Kyzylorda Oblast
- Askarov Syrym - Abdrakhmanova Symbat - Ertashova Dina - Makhataeva Zhuldyz - Aigul Kadirova - Amanova Zhanna - Miriam Iosue - Vladimir Carli - Marco Sarchiapone -

 Introduction:
According to the World Health Organization (WHO), Kazakhstan is among the countries with the highest suicide rates in the world. Furthermore, Kazakhstan is one of the countries that are experiencing the greatest level of mortality among adolescents (15-19 years) and young adults (20-24 years).
Several suicide prevention programs have been developed and there are evidences that school represents the best setting for these programs. For this reason, recently UNICEF Kazakhstan promoted the project "Prevention of suicide among minors".
 Methodology:
This large suicide prevention program tries to combine different approaches in order to maximize their effects. It includes a mental health awareness program for the adolescents, a gatekeeper training for the school staff and a screening program. Moreover, mental health professionals and general practitioners were specifically trained in order to improve their skills in treating adolescents with mental health problems and suicidal behavior.
In November 2015, a questionnaire, also including well validated scales (Depression Anxiety Stress Scale, Paykel Suicide Scale, etc.), has been administered to 33,069 adolescents. According to the cut-off scores of the different scales, 1,128 adolescents were identified as at risk. This group underwent a semi-structured interview in which 974 children were identified as at high risk. All the children were referred to a mental health service.

 Results:
Preliminary results of the suicide prevention program will be discussed in the poster.